Urogenital Tract Infection

Intraoperative Factors Associated With Postoperative Febrile Infectious Complications Following Retrograde Intrarenal Surgery: A Propensity Score-Matched Study: Wonjong Yang, Sangyong Park, Hee Sub Lee, Youngrak Jeong, Wonchul Lee, Hyung-Jee Kim, Seong Ho Lee, Justin Lee, Jong Keun Kim; Urogenit Tract Infect 2026;21(2):125-135. Published online August 31, 2026; DOI: https://doi.org/10.14777/uti.2652028.014

Abstract PDF PubReader ePub: Purpose
To investigate the intraoperative factors associated with postoperative febrile infectious complications following retrograde intrarenal surgery (RIRS). Materials and Methods: A total of 352 patients who underwent RIRS for renal stones between March 2017 and December 2022 were included in the analysis. Preoperative factors included age, sex, body mass index, underlying diseases, preoperative urine analysis results, and stone characteristics on computed tomography scans. Patients were divided into 2 groups based on the presence (group B) or absence (group A) of postoperative febrile infectious complications. Intraoperative factors—such as the degree of hydronephrosis on retrograde pyelography (RGP), stone impaction on endoscopic findings, size of the ureteral access sheath (UAS), grade of ureteral wall injury, operation time, and stone composition—were compared retrospectively.
Results
Postoperative febrile infectious complications occurred in 44 patients (12.6%). Following 1:3 propensity score matching, preoperative factors were analyzed for 44 patients (group B) and 132 patients (group A). Group B had a significantly longer hospital stay than group A (p=0.007); however, no significant differences were observed in postoperative pain (p=0.862) or stone-free rate (p=0.197). Hydronephrosis (odds ratio [OR], 7.31; 95% confidence interval [CI], 2.65–20.19) and high-grade ureteral wall injury (OR, 4.15; 95% CI, 1.88–9.12) were independently associated with postoperative febrile infectious complications, whereas no significant associations were observed for stone impaction, UAS size, operation time, or infectious stone composition.
Conclusions
Hydronephrosis identified on RGP and high-grade ureteral wall injury during RIRS were associated with postoperative febrile infectious complications and may serve as potential markers for risk stratification.

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Human Papillomavirus-Related Diseases in Urology: Diagnosis, Treatment, Prevention, and Clinical Considerations for Healthcare Providers: Kyu Won Lee, Amit Mani Upadhyay, Sangrak Bae; Urogenit Tract Infect 2026;21(2):56-73. Published online August 31, 2026; DOI: https://doi.org/10.14777/uti.2652020.010

Abstract PDF PubReader ePub: Human papillomavirus (HPV) has long been regarded as a gynecologic pathogen, yet its disease burden in men is substantial and rapidly increasing. In Korea, the prevalence of anogenital warts in men has tripled over the past decade, penile cancer continues to rise, and HPV-positive oropharyngeal cancer (OPC) incidence in men has already exceeded that of cervical cancer in comparable high-income countries. This review reframes HPV as an urgent urological, occupational, and public health concern. Drawing primarily on the 2023 Korean Sexually Transmitted Infection (STI) Guidelines and the 2021 U.S. Centers for Disease Control and Prevention STI Treatment Guidelines, supplemented by original primary literature retrieved from PubMed, we address: (1) the male-specific epidemiological shift; (2) nonsexual and occupational transmission routes, with particular emphasis on surgical smoke; (3) evidence-based infection control in urology practice; (4) clinical management of anogenital warts; (5) male HPV vaccination policy, international comparisons, and cost-effectiveness; and (6) future research priorities including OPC prevention, HPV and male infertility, and the need for urology-specific infection control guidelines. From 2026, Korea will include 12-year-old boys in its National Immunization Program—the first gender-neutral HPV vaccination policy in Korea. This review highlights the expanding and indispensable role of urologists in HPV management and emphasizes that infection control vigilance and gender-neutral vaccination strategies are essential to reduce the mounting societal burden of HPV-related diseases. This review provides a practical framework for urologists to integrate HPV prevention, infection control, and vaccination counseling into routine clinical practice.

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Role of Presepsin as a Predictive Factor for Sepsis in Patients With Urinary Tract Infection Associated With Ureteral Calculi: A Retrospective Cohort Study: Jong Gyun Ha, Hee Chang Jung, Yeong Uk Kim; Urogenit Tract Infect 2026;21(2):89-95. Published online August 31, 2026; DOI: https://doi.org/10.14777/uti.2652014.007

Abstract PDF PubReader ePub: Purpose
Recently, multiple studies have reported presepsin as a useful inflammatory biomarker for early sepsis diagnosis in patients with urinary tract infections (UTIs). Nonetheless, few studies have evaluated the efficacy of presepsin in urosepsis associated with ureteral calculi. We retrospectively investigated the efficacy of presepsin for early urosepsis diagnosis associated with ureteral calculi. Materials and Methods: Between May 2021 and July 2023, 64 patients with UTI associated with ureteral calculi were included. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score increase of ≥2 points. Patients were divided into 2 groups, with (n=38) and without (n=26) sepsis, and we assessed clinical characteristics (age, sex, and past medical history), laboratory data, and stone characteristics. Additionally, we evaluated predictive factors for urosepsis associated with ureteral calculi and compared these factors with inflammatory biomarkers.
Results
The proportion of females in the sepsis and nonsepsis groups was 89.5% (n=34) and 61.5% (n=16), respectively. In univariable analysis, low albumin level, low platelet count, and presepsin and procalcitonin (PCT) levels correlated with sepsis (p<0.05). In univariable logistic regression analysis, quick SOFA (odds ratio [OR], 2.071; p=0.033), C-reactive protein (CRP; OR, 1.08; p=0.01), PCT (OR, 1.025; p=0.008), and presepsin (OR, 1.354; p=0.001) were significantly associated with sepsis. In multivariate logistic regression analysis, presepsin (OR, 1.321; p=0.003) was significantly associated with sepsis. In receiver operating characteristic curve analysis of inflammatory markers, the areas under the curve for CRP, PCT, and presepsin were 0.704, 0.777, and 0.814, respectively.
Conclusions
Elevated presepsin levels may help predict sepsis occurrence in patients with UTI associated with ureteral calculi, thereby supporting timely and appropriate intervention.

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Efficacy of D-Mannose in the Management of Urinary Tract Infections: From Acute Treatment to Long-term Prophylaxis — A Systematic Review and Meta-analysis: Jae Yong Jeong, Young Joon Moon, Dong Hyuk Kang, Hae Do Jung, Lawrence Kim, Joo Yong Lee; Urogenit Tract Infect 2026;21(2):111-124. Published online August 31, 2026; DOI: https://doi.org/10.14777/uti.2652010.005

Abstract PDF Supplementary Material PubReader ePub: Purpose
To evaluate the efficacy of D-mannose for preventing recurrent urinary tract infections (UTIs), including in kidney transplant recipients, and to clarify discrepancies between early openlabel and placebo-controlled trials. Materials and Methods: PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and Web of Science were searched from inception to February 2026. Randomized controlled trials (RCTs) comparing D-mannose with placebo, no treatment, antibiotics, or active controls were included. Risk of bias (RoB) was assessed using RoB 2, and certainty of evidence using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations).
Results
Eleven RCT reports involving 1,724 participants were included; 10 independent study populations involving 1,631 participants contributed to quantitative analyses. In placebo-controlled trials, D-mannose did not significantly reduce UTI recurrence or persistence versus placebo (risk ratio [RR], 0.38; 95% confidence interval [CI], 0.06–2.36). No-treatment comparisons showed reduced recurrence (RR, 0.23; 95% CI, 0.08–0.66), but were more vulnerable to expectation, performance, and detection biases. The exploratory combined estimate favored D-mannose (RR, 0.28; 95% CI, 0.12–0.66), but certainty was very low. Antibiotic comparisons were inconclusive (RR, 0.43; 95% CI, 0.18–1.05), whereas proanthocyanidins active-control comparisons favored D-mannose-containing regimens (RR, 0.57; 95% CI, 0.40–0.82), including data from kidney transplant recipients.
Conclusions
Current placebo-controlled evidence does not establish superiority of D-mannose over placebo. Apparent benefits were mainly driven by no-treatment comparisons with very low certainty. D-mannose remains biologically plausible but clinically uncertain; adequately powered, double-blind, placebo-controlled trials are needed before firm recommendations can be made.

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Prevalence and Epidemiologic Characteristics of Acute Cystitis, Acute Pyelonephritis and Urinary Tract Infection: Population-Based Analysis Using Health Insurance Review and Assessment Service Bigdata From 2010 to 2024: Don Hee Lyu, Jae Chul Lee, Chang Hee Han, Sangrak Bae; Urogenit Tract Infect 2026;21(2):96-110. Published online August 31, 2026; DOI: https://doi.org/10.14777/uti.2652006.003

Abstract PDF PubReader ePub: Purpose
This study aims to investigate the long-term prevalence trends and epidemiological characteristics of acute pyelonephritis (APN), acute cystitis (AC), and other urinary tract infections (UTIs) in South Korea using nationwide big data. Materials and Methods: Data for ICD-10 (International Classification of Diseases, Tenth Revision) codes N10.0 (APN), N30.0 (AC), and N39.0 (UTI) were extracted from the Health Insurance Review and Assessment Service database from 2010 to 2024. Annual prevalence per 100,000 persons, sex and age-specific distribution, regional variations, and hospitalization/outpatient patterns were analyzed.
Results
The average annual prevalence per 100,000 was 344.4 for APN, 2,250.2 for AC, and 619.1 for UTI. AC reached its highest prevalence in 2024, despite a temporary decline in 2020. All conditions were more prevalent in females, with AC showing the highest male-to-female ratio of 1:20.4. A sharp 3.06-fold increase in APN prevalence was observed in females transitioning from ages 15–19 to 20–24 age group. Conversely, males showed a significant prevalence jump (1.43-fold) after age 80. In regional analysis, Gangwon State (469.5) and Jeju Special Self-Governing Province (177.9) recorded the highest and lowest APN prevalence, respectively. UTI required the longest hospitalization, while APN stays averaged 9.2 days for males and 9.0 days for females. An increase in related healthcare costs was also identified.
Conclusions
Age and sex are critical determinants of UTI epidemiology. The distinct spike in young females suggests a link to sexual activity, while the surge in elderly males likely correlates with prostatic conditions. These findings provide essential data for establishing targeted public health policies and clinical guidelines.

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Clinical and Environmental Reservoirs of Pseudomonas aeruginosa in Rural Tanzania: Implications for Diagnostics and Antimicrobial Stewardship: Philbert Balichene Madoshi, Theresia A. Karuhanga, Sandra Breum Andersen; Urogenit Tract Infect 2026;21(2):74-88. Published online August 31, 2026; DOI: https://doi.org/10.14777/uti.2550050025

Abstract PDF PubReader ePub: Purpose
Antimicrobial resistance (AMR) is making urinary tract infections (UTIs) and surgical site infections (SSIs) increasingly difficult to treat, especially in low-resource settings where self-medication and limited laboratory services are common. This study explored knowledge and practices related to AMR and investigated Pseudomonas aeruginosa from clinical and environmental reservoirs in Kilombero, rural Tanzania. Materials and Methods: A cross-sectional study was conducted over 9 months at St. Francis Regional Referral Hospital and selected community markets. Questionnaires were used to assess AMR awareness and antibiotic-use practices among community members and healthcare providers. Urine samples from pregnant women, SSI swabs, and fresh fish samples were collected. Fish were included as indicators of environmental reservoirs and possible foodborne exposure to P. aeruginosa. Presumptive isolates were confirmed using polymerase chain reaction targeting the OprI and OprL genes. Antimicrobial susceptibility testing followed EUCAST (European Committee on Antimicrobial Susceptibility Testing) 2021 guidelines.
Results
Only 34% of community participants correctly identified bacteria as causes of infection, while 19% had no knowledge of bacterial infections or AMR. Ciprofloxacin was the most commonly used antibiotic (49%), and self-diagnosis was frequently reported (35%), particularly among fish vendors. Poor hygiene practices, including hand-washing without soap, were also common. A total of 271 P. aeruginosa isolates were confirmed. Gentamicin showed the highest effectiveness across all sample sources, while resistance to meropenem and ciprofloxacin was substantial, especially among fish and SSI isolates.
Conclusions
Knowledge gaps, self-medication, and inconsistent hygiene coexist with the presence of P. aeruginosa in both clinical samples and fish representing environmental reservoirs Tanzania. Improved diagnostics, antimicrobial stewardship, hygiene practices, and community education are needed to strengthen AMR control using a One Health approach.

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Urinary Tract Infection and Urolithiasis: A Narrative Review of Pathophysiological Links and Clinical Implications: Dong Sup Lee; Urogenit Tract Infect 2026;21(1):3-10. Published online April 30, 2026; DOI: https://doi.org/10.14777/uti.2652002001

Abstract PDF PubReader: Urinary tract infection (UTI) and urolithiasis are closely related clinical entities that frequently coexist and influence each other’s pathogenesis and clinical course. Infection-related stones, particularly struvite and carbonate apatite stones, have long been recognized as consequences of ureaseproducing bacterial infections. However, recent evidence suggests that the role of microorganisms—especially Escherichia coli—in stone disease may extend beyond traditional infection stones; in particular, biofilm formation by microorganisms may contribute to the formation and growth of calcium-based stones. This review summarizes current knowledge on the pathophysiological mechanisms linking UTI and urolithiasis, with a focus on the biochemical processes underlying infection-related stone formation, the characteristics of different stone compositions, and emerging concepts regarding bacterial involvement in metabolic stone disease. A better understanding of the interplay between UTI and urolithiasis may improve preventive strategies, guide antimicrobial and surgical decision-making, and ultimately reduce recurrence rates. This review highlights the need for an integrated clinical approach that considers both infectious and metabolic factors in patients with urinary stone disease.

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Beyond Empirical Antibiotics: Toward Precision-Based Urinary Tract Infection Management and Korea-Specific Guidelines: Sang Rak Bae, Hee Jo Yang; Urogenit Tract Infect 2026;21(1):11-14. Published online April 30, 2026; DOI: https://doi.org/10.14777/uti.2550048024

Abstract PDF PubReader: Urinary tract infection (UTI) remains one of the most common bacterial infections, yet rising antimicrobial resistance and changing healthcare environments have challenged the traditional empiric approach to antibiotic therapy. Recent international guidelines from the European Association of Urology (EAU), Infectious Diseases Society of America (IDSA), and American Urological Association (AUA) collectively demonstrate a paradigm shift toward precision diagnostics, evidencebased antibiotic selection, standardized nonantibiotic prevention strategies, and simplified disease classification systems. The EAU has emphasized culture-based diagnosis, expanded nonantibiotic prophylaxis, and introduced a new framework distinguishing localized from systemic UTI. The IDSA has strengthened restrictions on treating asymptomatic bacteriuria, provided guidance for managing antimicrobial-resistant organisms, and simplified UTI categories. The AUA similarly highlights culture-directed diagnosis and the minimization of prophylactic antibiotics in women with recurrent UTI while formalizing nonantibiotic preventive measures. In Korea, unique resistance patterns, high extended-spectrum beta-lactamase and fluoroquinolone resistance rates, and frequent movement of patients between long-term care facilities and hospitals underscore the need for Korea-specific UTI guidelines. Although national surveillance systems such as KARMS (Korean Antimicrobial Resistance Monitoring System) and KorGLASS (Global Antimicrobial Resistance Surveillance System in Korea) provide valuable data, the evidence base remains insufficient to match the robustness of international guideline development. Establishing updated, Korean-contextualized UTI guidelines is essential for improving patient safety, optimizing antimicrobial stewardship, and effectively responding to the growing threat of resistance. The field is at a pivotal turning point, requiring proactive leadership and coordinated action within Korea’s urological and infectious disease communities.

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The Korean Antimicrobial Resistance Monitoring System for Complicated Urinary Tract Infections: A Prospective Multicenter Observational Study Conducted by the Korean Association of Urogenital Tract Infection and Inflammation: Seong Hyeon Yu, Seung Il Jung, Donghoon Lim, Jeong Woo Lee, Seung-Ju Lee, Hong Chung, Mi-Mi Oh, Jing Bong Choi, Jae Hung Jung, Hee Jo Yang, KAUTII Investigators; Urogenit Tract Infect 2026;21(1):15-25. Published online April 30, 2026; DOI: https://doi.org/10.14777/uti.2550040020

Abstract PDF PubReader: Purpose
This study aimed to report antimicrobial resistance (AMR) patterns among patients with complicated urinary tract infection (cUTI) using data from the Korean Antimicrobial Resistance Monitoring System (KARMS). Materials and Methods: In this prospective, multicenter, observational surveillance study, data from patients diagnosed with cUTI between January 2023 and September 2025 were retrieved from the KARMS database. Demographic characteristics, uropathogen distribution, and antimicrobial susceptibility profiles of representative pathogens were analyzed.
Results
Data from a total of 698 patients were collected in the KARMS database. The mean patient age was 68.94±15.95 years. The numbers of patients with healthcare-associated UTI and recurrent UTI were 171 (24.5%) and 240 (34.4%), respectively. Escherichia coli was the most frequently identified uropathogen (n=356, 51.1%). Regarding antimicrobial susceptibility, 92.9% of isolates were susceptible to fosfomycin, 75.5% to nitrofurantoin, 47.2% to ciprofloxacin, 63.3% to cefotaxime, 80.6% to piperacillin/tazobactam, and 98.8% to ertapenem. The rate of extended-spectrum beta-lactamase positivity was 45.2% (166 of 367) and was significantly higher in pyelonephritis and urosepsis (62.3% and 62.5%, p=0.002), healthcare-associated UTI (58.6%, p=0.040), and recurrent cUTI (53.2%, p=0.028). Fluoroquinolone resistance was significantly more common in female patients (49.1%, p=0.021) and in healthcare-associated UTI (57.9%, p=0.014). Piperacillin/tazobactam resistance was significantly higher in patients with urosepsis (37.0%, p=0.004), in tertiary hospitals (17.2%, p=0.019), and in healthcare-associated UTI (26.4%, p=0.001). In addition, third-generation cephalosporin resistance was significantly higher in secondary hospitals than in tertiary hospitals (43.5% vs. 33.3%, p=0.041).
Conclusions
These data provide current information on uropathogen distribution and AMR patterns in cUTI in South Korea. Continued surveillance and ongoing data accumulation through KARMS will support evidence-based strategies for optimal antimicrobial therapy and AMR mitigation.

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Diagnostic Utility of the Sysmex UF-5000 Flow Cytometer in Acute Bacterial Prostatitis: A Retrospective Pilot Study: Young Kyu Han, Jeong Woo Lee, Hae-Il Park, Jin Bong Choi; Urogenit Tract Infect 2025;20(2):107-113. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550022011

Abstract PDF Supplementary Material PubReader

Purpose
To evaluate the diagnostic performance of the Sysmex UF-5000 flow cytometer in detecting acute bacterial prostatitis (ABP) compared to standard urine culture. Materials and Methods: This retrospective study analyzed 45 urine samples from patients with a clinical diagnosis of ABP. Each sample was evaluated using the UF-5000 to measure red blood cells (RBC), white blood cells (WBC), and bacterial counts, and the results were compared with those from standard urine culture and Gram staining. Receiver operating characteristic curves were generated, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value were determined. Concordance between Gram classification by the UF-5000 and conventional Gram staining was also evaluated.
Results
Of the 45 patients, 84.4% had positive urine cultures. The bacterial count parameter demonstrated the highest diagnostic performance (area under the curve [AUC]=0.79; sensitivity, 89.5%; PPV, 91.9%), outperforming WBC (AUC=0.76) and RBC (AUC=0.55). The Gram classification flag showed an overall concordance of 85.7% with conventional Gram staining, with a concordance rate of 88% for Gram-negative organisms.
Conclusions
The Sysmex UF-5000 exhibited good concordance with urine culture for patients with ABP, particularly through the bacterial count parameter. Although it does not replace culture, the UF-5000 may serve as a rapid adjunctive tool to support early clinical decision-making in suspected ABP cases.

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Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef
A Commentary on “Diagnostic Utility of the Sysmex UF-5000 Flow Cytometer in Acute Bacterial Prostatitis: A Retrospective Pilot Study”
Dong-Hoon Lim
Urogenital Tract Infection.2025; 20(3): 173. CrossRef

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Molecular Mechanisms of Antibiotic Resistance in Uropathogenic Escherichia coli: A Narrative Review: Nakjun Choi, Dong Uk Kim, Eun-Jin Lee; Urogenit Tract Infect 2025;20(2):96-106. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550018009

Abstract PDF PubReader

Urinary tract infections (UTIs) are among the most prevalent bacterial infections worldwide, with uropathogenic Escherichia coli (UPEC) serving as the primary causative agent. Although antibiotic therapy remains the standard of care for UTI treatment, the increasing prevalence of antimicrobial resistance has substantially reduced the effectiveness of commonly prescribed antibiotics. Resistance to trimethoprim-sulfamethoxazole (TMP-SMX), β-lactams, and fluoroquinolones is particularly concerning, as these agents constitute the principal therapeutic options for UTIs. This review examines the molecular mechanisms underlying UPEC resistance to these three classes of antibiotics, including target site modifications, efflux pump overexpression, porin regulation, and enzymatic degradation. Furthermore, it explores how these resistance determinants contribute to the development of multidrug-resistant (MDR) UPEC strains, which demonstrate cross-resistance to multiple antibiotics and present significant challenges for clinical management. Novel therapeutic strategies, such as efflux pump inhibitors, bacteriophage therapy, and genomic-guided precision medicine, are under investigation as potential solutions to address the growing global burden of MDR UPEC, alongside alternative non-antibiotic treatments. This review aims to provide a comprehensive overview of the genetic and regulatory pathways driving antibiotic resistance in UPEC, offering insights that may guide the development of effective treatment strategies and help mitigate the ongoing spread of antimicrobial resistance.

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Biological mechanisms and social determinants of antimicrobial resistance
Madhulika Bajpai, Tanisha Saraf, Urmi Bajpai
Biochemical and Biophysical Research Communications.2026; 828: 154075. CrossRef
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Samaa Sameh Bakr, Dina Eid Rizk, El Sayed E. Habib, Enas Yasser Sultan
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Rapid diagnostics innovations for urinary tract infections using molecular biology, artificial intelligence and antimicrobial resistance surveillance: a comprehensive review
Soniya Goyal, Pooja Sharma, Deepak Aggarwal, Sameer Singh Faujdar
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Lakshi Sihara Jayasekara, Bharath Reddy Boya, Jin-Hyung Lee, Jintae Lee
Journal of Applied Microbiology.2026;[Epub] CrossRef
Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef

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The Role of the Urinary Microbiome in the Prevention of Pediatric Urinary Tract Infections: A Narrative Review: Byeongdo Song; Urogenit Tract Infect 2025;20(2):82-95. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550016008

Abstract PDF PubReader

Urinary tract infections (UTIs) are a common condition in children and often lead to hospitalization. A considerable proportion of children with UTIs (up to 30%) experience at least one recurrence, placing them at risk for long-term complications such as renal scarring. Since the concept of the microbiome was first introduced in 2001, increasing attention has been given to the role of the urinary tract microbiome in maintaining urinary tract homeostasis. Dysbiosis of the urinary microbiome has been recognized as a factor associated with an increased risk of various urinary tract diseases, including UTIs. However, the specific role of the urinary microbiome in the pathophysiology of pediatric UTIs remains incompletely understood. The present review examines recent studies on the urinary microbiome in children and summarizes current strategies for modulating the urinary microbiome to prevent UTI recurrence in the pediatric population.

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Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef

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Beta-Lactamase-Mediated Antibiotic Resistance in Urinary Tract Infections: Mechanisms and Therapeutic Strategies: Fanglin Shao, Dengxiong Li, Jie Wang, Zhouting Tuo, Zhipeng Wang, Wuran Wei, Ruicheng Wu, Dechao Feng; Urogenit Tract Infect 2025;20(2):67-81. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550012006

Abstract PDF PubReader

Urinary tract infections (UTIs) are among the most prevalent bacterial infections globally, and are primarily caused by Escherichia and Klebsiella. The overprescription and inappropriate use of antibiotics have accelerated the emergence of multidrug-resistant bacteria. Beta-lactamases play a critical role in mediating antibiotic resistance in UTIs. These enzymes promote bacterial resistance through multiple mechanisms, including gene mutation, plasmid-mediated horizontal gene transfer, and the involvement of integrons. Comprehensive knowledge of the ways in which beta-lactamases contribute to resistance in UTIs is essential for improving treatment strategies. Advances in detection technologies, such as gene sequencing and mass spectrometry, have greatly enhanced the ability to monitor and predict bacterial resistance. Current therapeutic strategies include the application of beta-lactamase inhibitors, the development of novel antibiotics, and alternative treatments that have shown efficacy against beta-lactamase-mediated antibiotic resistance. This paper reviews the mechanisms of beta-lactamase-mediated resistance in UTIs and provides an in-depth overview of several detection methods and therapeutic approaches.

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Erosion of empirical therapy: a multi-regional cross-sectional study of antimicrobial resistance in community-acquired urinary tract infections in Lebanon
Soumaya Hijazi, Souraya Domiati, Kamar Al Halabi, Zeina Ayash, Mira El Charif, Bahia Maatouk, Deema Rahme
International Journal of Infectious Diseases.2026; 170: 108828. CrossRef
Prevalence and β-Lactam Resistance of Enterobacterales Isolated from Urinary Samples in a Regional Hospital in Poland: Special Emphasis on Elderly Population
Łucja Dudzik, Paweł Migdał, Piotr Misiąg, Paweł Krzyżek, Ewa Dworniczek
Pathogens.2026; 15(8): 840. CrossRef
Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef

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Asymptomatic Bacteriuria in Older Adults – Diagnosis, Management, and Future Directions: A Narrative Review: Ki Hong Kim, Hee Jo Yang; Urogenit Tract Infect 2025;20(2):58-66. Published online August 31, 2025; DOI: https://doi.org/10.14777/uti.2550002001

Abstract PDF PubReader

Asymptomatic bacteriuria (ASB) is defined as the presence of bacteria in the urine in the absence of urinary tract infection (UTI) symptoms. The prevalence of ASB increases with advancing age, particularly among older patients with underlying health conditions. ASB is especially common among residents of long-term care facilities; however, distinguishing ASB from symptomatic UTI in this population remains a significant clinical challenge. The frequent occurrence of ASB often results in unnecessary antibiotic administration, thereby contributing to the development of antibiotic resistance. Current clinical guidelines recommend screening for and treating ASB only in certain circumstances, such as prior to urological procedures or in pregnant women. There is a pressing need for improved diagnostic approaches to differentiate ASB more accurately from UTI, particularly in older adults. Reducing unnecessary urine testing and inappropriate antibiotic use may help prevent over-treatment and minimize associated risks, including Clostridium difficile infection and increased antimicrobial resistance.

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Effect of systemic enzyme therapy on the incidence of stentassociated infectious complications in female patients with urolithiasis: a multicentre study
S. V. Kotov, A. A. Nemenov, R. A. Perov, I. E. Mamaev, S. V. Belomyttsev, S. A. Pulbere, A. D. Bolotov
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In Vitro Activity of Mecillinam Against ESBL- and Non-ESBL-Producing Escherichia coli and Klebsiella pneumoniae Urinary Isolates
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Acta Microbiologica Hellenica.2026; 71(3): 33. CrossRef
Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(2): 55. CrossRef

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Advances in the Diagnosis of Urinary Tract Infection: A Narrative Review: Juan Victor Ariel Franco, Nicolás Meza; Urogenit Tract Infect 2025;20(1):17-27. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550020010

Abstract PDF PubReader ePub

Urinary tract infections are among the most frequent bacterial infections, significantly impacting patient morbidity and healthcare resources. Prompt and accurate diagnosis is crucial to ensure effective treatment, prevent complications such as pyelonephritis or sepsis, and reduce inappropriate antibiotic use, contributing to antimicrobial resistance (AMR). Despite consensus across international guidelines from organizations, challenges persist, particularly in distinguishing true infections from asymptomatic bacteriuria or nonspecific symptoms, especially in older adults. Recent advancements in diagnostic technology have emerged to address these limitations, including molecular diagnostics, point-of-care testing (POCT), and artificial intelligence (AI)-driven predictive models. Molecular techniques, notably polymerase chain reaction, loop-mediated isothermal amplification, and metagenomic next-generation sequencing, offer enhanced sensitivity and specificity, rapid detection times, and comprehensive identification of pathogens and resistance profiles. POCT innovations, such as lateral flow immunoassays, enzymatic-based rapid tests, and novel biosensors, facilitate prompt bedside diagnosis, although specificity challenges remain. Meanwhile, AI and machine learning models demonstrate significant potential for risk stratification, prediction of infection, and improving antibiotics prescription practices yet face barriers related to validation, practical integration, and clinical acceptability. Despite promising developments, significant gaps remain, including limited real-world implementation evidence, high costs, and insufficient data from diverse populations. Further rigorous clinical studies, economic evaluations, and practical implementation assessments are urgently required. Addressing these research gaps could substantially improve patient outcomes, optimize antibiotic stewardship, and reduce the global burden of AMR.

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Current Microbiology.2026;[Epub] CrossRef
Comparison of OneChoice AI-Based Clinical Decision Support Recommendations with Infectious Disease Specialists and Non-Specialists for Empirical Urinary Tract Infection Therapy in Lima, Peru
Juan Carlos Gómez de la Torre, Ari Frenkel, Carlos Chavez-Lencinas, Alicia Rendon, Max Fabian, José Alonso Cáceres-DelAguila, Diana Minchon-Vizconde, Miguel Hueda-Zavaleta
Diagnostics.2026; 16(17): 2708. CrossRef
Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef

17,754 View
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Emerging Insights Into Microbiome Therapeutics for Urinary Tract Infections: A Narrative Review: Hoonhee Seo, Md Abdur Rahim, Indrajeet Barman, Mohammed Solayman Hossain, Hanieh Tajdozian, Fatemeh Ghorbanian, Md Sarower Hossen Shuvo, Jiho Choi, Sukyung Kim, Heejo Yang, Ho-Yeon Song; Urogenit Tract Infect 2025;20(1):4-16. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2448034017

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Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, affecting millions annually and posing a significant global health concern. Traditional therapies for UTIs are becoming increasingly ineffective due to rising drug resistance and their tendency to disrupt the host's healthy microbiota, leading to further side effects. Consequently, there is an urgent need to develop alternative therapeutic agents that differ from conventional regimens and have fewer or no side effects. In this context, microbiome therapeutics offer a promising solution, given their demonstrated efficacy against various infectious diseases. Advances in scientific technology, particularly next-generation sequencing, have deepened our understanding of urinary microbiome dynamics, revealing a complex interplay within the urobiome that influences the onset and progression of UTIs. Uropathogenic bacteria do not solely cause UTIs; shifts in the composition of the urinary microbiome and interactions within the microbial community, known as host-microbiota interactions, also play a significant role. Although recent studies underscore the potential of targeting the urinary microbiome to manage UTIs and related complications, this field is still emerging and faces numerous regulatory and technical challenges. Further in-depth and comprehensive research is required to advance this pioneering concept into clinical practice.

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Mechanisms Linking Recurrent Bacterial Urinary Tract Infections to Chronic Kidney Disease Progression
Mariana-Emilia Caragea, Daniel Cosmin Caragea, Mohamed-Zakaria Assani, Isabela Siloși, Mihail Virgil Boldeanu, Lucrețiu Radu, Lidia Boldeanu, Cristin Constantin Vere
International Journal of Molecular Sciences.2026; 27(11): 4999. CrossRef
Editorial for UTI 2025 Vol. 20 No. 1 - Highlights of This Issue’s Papers and the UTI Editors’ Pick
Koo Han Yoo
Urogenital Tract Infection.2025; 20(1): 1. CrossRef
Efficacy and safety of N-acetylcysteine vs. probiotics in in-vivo biofilm prevention on ureteral stents: a prospective randomized controlled pilot in vivo study
Iqbal Singh, Himanshu Agrawal, Shailender Maurya, Himanshu Tanwar, Sanjay Gupta, N. P. Singh
International Urology and Nephrology.2025; 58(3): 811. CrossRef

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Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series: Beomsoo Kim, Young-Sin Choi, Jun-Koo Kang, Yun-Sok Ha, Seock Hwan Choi, Bum Soo Kim, Hyun Tae Kim, Eun Sang Yoo, Tae Gyun Kwon, Jae-Wook Chung, Tae-Hwan Kim; Urogenit Tract Infect 2024;19(3):97-103. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448028014

Abstract PDF PubReader ePub

Purpose
This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital. Materials and Methods: From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process.
Results
P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests.
Conclusions
This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.

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A Commentary on “Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series”
Byoungkyu Han
Urogenital Tract Infection.2025; 20(1): 52. CrossRef

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Mechanistic Insights Into Persistent Bacterial Cystitis as a Basis for Vaccine Development: A Narrative Review: Karen Serrano-Arevalo, Manisha Naskar, Hae Woong Choi; Urogenit Tract Infect 2024;19(3):60-72. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448022011

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Urinary tract infections (UTIs) are primarily caused by uropathogenic Escherichia coli (UPEC), which frequently lead to recurrent infections. These bacteria utilize several strategies to establish infection in the host; in particular, virulence factors such as fimbriae and α-hemolysin facilitate persistent infection, evade host immune responses, and minimize antibiotic exposure. To date, antibiotics have been the primary treatment for UTIs. However, an increasing emphasis has been placed on the need for UTI vaccines, with mucosal vaccine products now available in several countries. Additionally, vaccines targeting intracellular UPEC, utilizing adjuvants, are currently under development. Understanding the pathogenic mechanisms of uropathogens has enabled the development of new treatment approaches, paving the way for next-generation preventive and therapeutic methods that could effectively manage recurrent UTIs in the future.

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Mechanisms and clinical implications of bacterial persistence in recurrent urinary tract infections
Changil Choi, Dong Soo Kim, Jin Bong Choi, Taesoo Choi, Jeong Woo Lee
Investigative and Clinical Urology.2026; 67(2): 123. CrossRef
Antivirulence strategies targeting adhesion and biofilm formation in uropathogenic E. coli: Recent advances and clinical perspectives-review
Amina Bougouizi, Astri Dwyanti Tagueha, Lucia Nencioni, Cecilia Ambrosi, Daniela Scribano
Microbial Pathogenesis.2026; 219: 108757. CrossRef
Bacterial biofilm – as a contributor to urinary tract infections
Zuzanna Trześniewska-Ofiara, Mariola Mendrycka, Agnieszka Woźniak-Kosek
Biuletyn Głównej Biblioteki Lekarskiej.2025; 58(384): 83. CrossRef

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Trend Analysis of Sexually Transmitted Infection Treatments in Korea: Soeon Park, Byung Kyu Han, Sangrak Bae, Seung-Ju Lee, Jin Bong Choi; Urogenit Tract Infect 2024;19(2):25-30. Published online August 31, 2024; DOI: https://doi.org/10.14777/uti.2024.19.2.25

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Purpose: The revision of the 2023 Guidelines for the Treatment of Sexually Transmitted Infections (STIs) has been released. Hence, it is necessary to analyze the current status of STI treatments in Korea.
Materials and Methods: A questionnaire was distributed to urologists and gynecologists from December 2022 to January 2023 through an online survey program. Three hundred and forty-one urologists and 302 gynecologists responded to the questionnaire.
Results: For Neisseria gonorrhea treatment, ceftriaxone 500 mg and 100 mg of doxycycline twice daily for seven days were most preferred by urologists (22.58%). The treatment most preferred by gynecologists (15.23%) was 500 mg of ceftriaxone and 1 g of azithromycin in a single dose. Both urologists and gynecologists generally treat Chlamydia trachomatis according to the treatment guidelines. For treating Mycoplasma genitalium, 29.03% of urologists preferred administering azithro-mycin at 500 mg once daily, followed by 250 mg for four days. In contrast, 33.11% of gynecologists preferred doxycycline 100 mg twice daily for seven days.
Conclusions: Most urologists and gynecologists followed the treatments recommended in the 2nd edition of the STI treatment guidelines, revised in 2016. As many treatment regimens have changed because of the recent increase in antibiotic-resistant STIs, there is a need to encourage them to follow the new treatment guidelines.

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Prevalence of sexually transmitted infections among persons aged 15–24 in the Republic of Korea: A retrospective population-based descriptive study
Jinhee Seo, Minji Han, Sangrak Bae, Sooyoun Kim
Investigative and Clinical Urology.2026; 67(2): 201. CrossRef
Comparative Study of the Clinical Characteristics of Patients With Sexually Transmitted Infections Diagnosed by Nucleic Acid Amplification Tests
Jung Soo Son, Namhee Kim, Hong Sang Oh, Sang Won Park, Dong Hoon Shin
Journal of Korean Medical Science.2025;[Epub] CrossRef

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Spontaneous Bladder Perforation in a Patient with a Long-Term Intraurethral Catheter: Taegi Choi, Hyunkyung Lee, Junseok Kim, Sunghoon Lee, Younkyung Cho, Eunyoung Kang, Jinsun Kang, Sumin Lee, Eunju Na; Urogenit Tract Infect 2023;18(3):110-113. Published online December 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.3.110

Abstract PDF PubReader ePub: Urinary catheters are commonly used to address various urinary problems. However, the catheter itself can be a cause of several complications, including catheter-associated urinary tract infections, damage to the bladder and kidneys, and, in extremely rare cases, bladder perforation. We present a case of spontaneous bladder perforation in a patient who had a long-term indwelling intraurethral catheter. The patient with prior hypoxic brain damage suddenly developed tachypnea, tachycardia, and oxygen desaturation. Computed tomography and retrograde cystography revealed an extraperitoneal bladder perforation with an intra-pelvic abscess. Antibiotics were prescribed and a urinary catheter was inserted for drainage. After 11 weeks, the abscess resolved, and the catheter was removed to enable self-voiding. The perforation was attributed to chronic inflammation and distension of the bladder wall caused by the intraurethral catheter. Given the potential complications associated with long-term urinary catheterization, the timely removal of indwelling catheters should be considered.

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Impact of Microbial Infection on Sperm Parameters of Seminal Bacteria in Asymptomatic Subfertile Males: Sae Byuk Chang, Tae Jin Kim, Tae Heon Kim, Seung-Ryeol Lee, Young Kwon Hong, Dong Soo Park, Sun-Mi Cho, Dong Hyeon Lee, Young Dong Yu; Urogenit Tract Infect 2023;18(3):82-92. Published online December 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.3.82

Abstract PDF PubReader ePub

Purpose: This study examined the effects of asymptomatic bacteriospermia on the semen quality of subfertile males. The types of bacteria and their antibiotic susceptibility were also analyzed.
Materials and Methods: Semen was collected and analyzed from 510 subfertile males. One hundred and seventy-nine males showed bacteriospermia, while 331 males did not. The bacterial species, sperm parameters, hormone levels, underlying disease, and lifestyle patterns were compared between the two study groups.
Results: The bacteriospermic males showed significantly higher rates of leukocytospermia (p=0.001) and deoxyribonucleic acid (DNA) fragmentation than the non-bacteriospermic males. Sperm motility was significantly lower in the bacteriospermic males than in non-bacteriospermic males. The most common seminal bacterial species were Prevotella bivia (P. bivia, 41.3%) and Ureaplasma urealyticum (U. urealyticum, 13.4%). U. parvum showed the highest recurrence rates (31.8%) three months after the initial antibiotic treatment. Regarding the sperm parameters of bacteriospermic males, the sperm concentration, total motility, progressive motility, leukocytospermia, and DNA fragmentation were improved significantly after the initial antibiotics treatment. Multivariate logistic regression analyses revealed P. bivia, U. urealyticum, and U. parvum to be associated with the decreased motility and increased DNA fragmentation of spermatozoa. P. bivia was also associated with a decreased sperm concentration (p=0.002) and vitality (p=0.013).
Conclusions: Bacteriospermia decreased the sperm concentration, motility, normal morphology, and vitality. P. bivia is the most commonly observed bacteria in subfertile males. Appropriate antibiotic therapy of seminal bacteria species had a strong positive impact on improving the semen parameters.

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Male Infertility in Burkina Faso: Analysis of Epidemiological, Diagnostic, and Therapeutic Profiles in a University Hospital
Clotaire Alexis Marie Kiemdiba Donega Yaméogo, Hassami Sawadogo, Brahima Kirakoya, Abdoul-Karim Pare, Soutongnoma Abdoul Euloge Kagambega, Adama Ouattara, Fasnewinde Aristide Kabore
Open Journal of Urology.2025; 15(11): 555. CrossRef

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Feasibility of Anesthesia-Free Ureteroscopic Lithotripsy in Elderly Patients with Urinary Tract Infections: Duk Yoon Kim, Hyun Jin Jung, Eun Kyoung Yang, Won Yeol Cho; Urogenit Tract Infect 2023;18(2):60-63. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.60

Abstract PDF PubReader ePub: Purpose: Patients with underlying diseases, particularly in the elderly, urinary tract obstruction with a ureter stone would progress to severe conditions. Some of them have poor general conditions to endure anesthesia. Therefore, this study validated the feasibility of ureteroscopic stone removal without anesthesia for elderly patients with ureter stones who were under impending septic conditions or severe urinary tract infections.
Materials and Methods: Thirty-four patients (16 males and 18 females) were included in this study. All of them had serious problems, making it difficult to endure anesthesia. Most of them were inserted pre-operative percutaneous nephrostomy catheter, and ureteroscopic lithotripsy was performed successfully after intravenous analgesic injection (pethidine 25 mg).
Results: The mean age was 71.8±10.84 years. The locations of the stones were upper ureter in 11, mid-ureter in 6, and lower ureter in 17 cases. Urine and blood cultures identified bacteria from 17/34 patients. Escherichia coli was the most common (10/17), followed in order by Klebsiella pneumoniae and Staphylococcus epidermidis in 5 and 2 cases, respectively. Most patients had an abnormal white blood cell count (19,400±4,233.3/l) and elevated C-reactive protein levels (110.3±83.6 mg/L). No patient had to stop the operation because of intolerable pain. The mean of the visual analog pain scale was 3.2±0.86. The overall success rate was 100%.
Conclusions: The trial of ureteroscopic lithotripsy after administering analgesics could improve the condition of elderly patients whose general condition is too poor to endure anesthesia without serious complications.

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Is Human Mpox a New Sexually Transmitted Infection in Korea That Should Be Monitored?: Gilho Lee; Urogenit Tract Infect 2023;18(2):35-44. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.35

Abstract PDF Supplementary Material PubReader ePub: Human monkeypox (mpox) outbreaks have been reported in more than 110 countries, with more than 86,930 confirmed cases. The World Health Organization has realized the seriousness of personal transmission and has declared a global health emergency against the infection. Traditionally, contact with infected animals in a few endemic countries has been a major transmission route of the mpox virus. On the other hand, the global mpox outbreak in 2022 has been primarily associated with sexual networks of men who have sex with men (MSM) and bisexual men exhibiting high-risk behaviors. Their common symptoms are initial fever, headache, swollen lymph nodes, and subsequent skin rashes. These presentations did not consistently occur in the 2022 outbreak. Many patients presented with skin lesions on the anogenital areas without prodromal symptoms. In addition, the atypical characteristics of the recent outbreak may result in a misdiagnosis of other skin lesions, such as chickenpox. Furthermore, infected persons are frequently co-infected with sexually transmitted infections (STIs) with similar skin lesions. The newly confirmed cases in Korea on April 2023 must have been infected through community transmission because these new patients had not traveled overseas in the past three months. Therefore, mpox is something that everybody should be concerned about in Korea. Medical practitioners must know the characteristics of the infection because patients with mpox may visit their offices with some genital lesions or other STIs. The clinical information from this paper may broaden and deepen the understanding of human mpox and curb the early transmission of the infection.

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Prophylactic Antimicrobial Therapy and Antimicrobial Stewardship in Urologic Surgery: Hee Jo Yang; Urogenit Tract Infect 2023;18(1):8-14. Published online April 30, 2023; DOI: https://doi.org/10.14777/uti.2023.18.1.8

Abstract PDF PubReader ePub

Postoperative infectious complications are a worrying problem for surgeons. Urological surgery has a higher risk of postoperative urinary tract infection than other surgeries because of the common use of various types of catheters. Due to the recent increase in antibiotic resistance, antimicrobial stewardship recommends using appropriate antibiotics for a suitable period. It is generally advocated that prescribing antibiotics in the absence of infection is equivalent to the inappropriate use of antibiotics. Based on numerous studies reported by several academic societies, appropriate use of antibiotics before surgery has been suggested. It was confirmed that using antibiotics according to these guidelines reduces the use of antibiotics without increasing the incidence of postoperative infectious complications. Furthermore, endourological surgery reports have proved the efficacy of antibiotics given once before surgery. Differences in antibiotic resistance by region must be taken into consideration when selecting the appropriate antibiotic type.

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Safety of Omitting Antimicrobial Prophylaxis in Laparoscopic Donor Nephrectomy: A Prospective Observational Study
Shivam Mishra, Kunal Vinayak, Rahul Bhan, Venkatesh Singhal, Abhinandan Mukhopadhyay, Varun Mittal
Indian Journal of Transplantation.2026; 20(1): 43. CrossRef

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Evaluating Family Physicians’ Knowledge of Urinary Tract Infection in Southern Iran: Scale Development: Hourvash Haghighinejad, Parisa Jooya, Raziye Saeedizade, Kaveh Taghipour, Fatemeh Malekpour; Urogenit Tract Infect 2023;18(1):24-31. Published online April 30, 2023; DOI: https://doi.org/10.14777/uti.2023.18.1.24

Abstract PDF PubReader ePub: Purpose: Urinary tract infections (UTIs) often present with nonspecific symptoms in childhood and can result in serious complications. Therefore, it is imperative for the proper diagnosis, treatment, and follow-up of this affliction. We first designed a valid and reliable questionnaire. Subsequently, the study evaluated the knowledge of family physicians regarding pediatric UTI.
Materials and Methods: A questionnaire was designed to evaluate the family physicians’ knowledge of pediatric UTIs. The face and content validity and reliability of the questionnaire were first evaluated in a pilot study. Subsequently, doctors were asked to complete the questionnaire and data-collecting form delivered at their workplace.
Results: The validity and reliability of the questionnaire were deemed acceptable after omitting two questions. Cronbach's alpha of the final questionnaire was 0.71. More than 75% of the participants answered each question correctly. Approximately 50% of the physicians were post-graduates. Age was determined to be negatively correlated, and the "number of years of graduation" was positively correlated with the total score of the questionnaire.
Conclusions: The designed questionnaire had acceptable validity and reliability. Moreover, family physicians’ knowledge of pediatric UTIs was found to be favorable.

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Differences in Urine Microbiome of Acute Cystitis and Chronic Recurrent Cystitis in Women: Woong Bin Kim; Urogenit Tract Infect 2023;18(1):1-7. Published online April 30, 2023; DOI: https://doi.org/10.14777/uti.2023.18.1.1

Abstract PDF PubReader ePub: The diagnosis of urinary tract infection (UTI) relies on urine culture tests to identify aerobic or anaerobic urinary tract pathogens. This method has limitations in identifying anaerobic bacteria, and there is uncertainty in identifying all bacteria. A new next-generation sequencing (NGS) method has gradually helped overcome these limitations, and the microorganisms present in the human urinary tract are gradually being revealed. This review introduces studies on the microbiome analyzed using NGS of urine from patients with acute cystitis and recurrent UTIs and discusses whether NGS may reveal the pathophysiology of the disease.

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Treatment Modality of Prostatic Abscess according to Size: A Retrospective Study: Gwon Kyeong Lee, Kyoung Ha Jang, Woo Seop Seong, Byeong Jin Kang, Kyung Hwan Kim, Hong Koo Ha; Urogenit Tract Infect 2022;17(3):96-102. Published online December 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.3.96

Abstract PDF PubReader ePub

Purpose: This study aimed to determine the treatment modality for prostatic abscesses according to size.
Materials and Methods: Twenty-five patients diagnosed with prostatic abscesses were retrospectively reviewed. All patients were treated with intravenous empirical and appropriate antibiotics according to culture results. They were grouped according to the size of the prostate abscess based on computed tomography results (group A, with prostate abscess ≤2 cm, n=10; group B, with prostate abscess size >2 cm, n=15), and their treatment modality and outcomes were compared.
Results: The prostatic abscess sizes were 1.31±0.37 and 3.49±1.06 cm for groups A and B, respectively. Prostate-specific antigen, prostatic volume, and comorbidity were not significantly different (p>0.05), whereas pelvic pain was significantly different (p=0.028). There was no difference in the microorganisms isolated from urine and blood culture, empirical antibiotics, and broad-spectrum antibiotics between the two groups (p>0.05). More patients in group B underwent transurethral abscess deroofing than those in group A (p=0.040). Patients in group B had a more extended hospitalization period and intravenous antibiotics duration than those in group A (p=0.024 and p=0.013, respectively). Group B had more cases of septic shock, intensive care unit admission, and mortality events than group A (p=0.024, p=0.001, and p=0.061, respectively). However, prostatic abscess recurrence and urological chronic complication did not significantly differ (p>0.05).
Conclusions: Appropriate use of antibiotics is crucial. This study shows that the treatment of patients with prostatic abscess >2 cm is more difficult, but transurethral abscess deroofing can lower mortality, prostatic abscess recurrence, and urological chronic complications.

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Risk factors for mortality in prostatic abscess: Insights into patient characteristics and drainage practices
Yun-Chen Tsai, Jian-Ri Li, Chiann Yi Hsu, Che-An Tsai, Benjamin M. Liu
PLOS One.2026; 21(6): e0349673. CrossRef

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Korean Multicenter Study of Infectious Complications after Transurethral Prostate Surgery in Patients with Preoperative Sterile Urine: Seong Hyeon Yu, Seung Il Jung, Eu Chang Hwang, Tae-Hyoung Kim, Jae Duck Choi, Koo Han Yoo, Jeong Woo Lee, Dong Hoon Koh, Sangrak Bae, Seung Ok Yang, Joongwon Choi, Seung Ki Min, Hoon Choi; Urogenit Tract Infect 2022;17(3):81-88. Published online December 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.3.81

Abstract PDF PubReader ePub

Purpose: To evaluate the efficacy of antibiotic prophylaxis and determine the risk factors of infectious complications after transurethral surgery of the prostate.
Materials and Methods: Seven hundred and seventy-two patients who underwent transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HOLEP) were reviewed. Of these, this study enrolled 643 patients without bacteriuria who had not received antibiotics for urinary tract infections for two weeks before surgery. The patients were divided into two groups according to the duration of the antibiotics (Group 1: less than one day, n=396 vs. Group 2: more than one day, n=247).
Results: The overall incidence of postoperative infectious complications in 643 patients was 5.0% (32/643). When postoperative infectious complications were compared according to the duration of the antibiotics (Group 1 vs. Group 2), the infectious complications rates were 5.6% (22/396) vs. 4.0% (10/247), respectively (p=0.393). When postoperative infectious complications were compared according to the duration of antibiotics (Group 1 vs. Group 2) in the TURP and HOLEP groups, the infectious complications rates were 6.3% (12/192) vs. 1.0% (1/103) (p=0.035) and 4.9% (10/203) vs. 6.0% (8/134) (p=0.677), respectively. The duration of Foley catheterization was independently associated with infectious complications (p=0.003).
Conclusions: The results showed that prolonged postoperative catheterization affects postoperative infectious complications associated with transurethral prostate surgery. Although antibiotics administered for less than one day are effective for antibiotic prophylaxis of transurethral prostate surgery, a longer antibiotic therapy is recommended for TURP.

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Evaluation of Postoperative Urinary Tract Infection and Sepsis Rates After Adding Cystolitholapaxy to HoLEP: A Retrospective Analysis
Federico Rovegno, Rajiv Pillai, Zafar Maan, Soumendra Datta, Omar Nasir, Gerald Rix
International Journal of Clinical Urology.2026; 10(1): 1. CrossRef
Comparison of HoLEP Outcomes Between Catheterized and Non‐Catheterized Patients: A Propensity Score–Matched Analysis
Caglar Dizdaroglu, Ufuk Caglar, Arda Meric, Cagri Yaman, Faruk Ozgor, Omer Sarilar
LUTS: Lower Urinary Tract Symptoms.2026;[Epub] CrossRef

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Changes of Causative Organism and Antimicrobial Resistance in Urinary Tract Infections After the COVID-19: Young Ho Choi, Jong Hyun Tae, Mi-Kyung Lee, Tae-Hyoung Kim; Urogenit Tract Infect 2022;17(2):42-49. Published online August 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.2.42

Abstract PDF PubReader ePub

Purpose: During the coronavirus disease 2019 (COVID-19) pandemic, several studies reported changes in the distribution of microorganisms that cause major legal, respiratory, and gastrointestinal infectious diseases and increases in the antimicrobial resistance rates in Korea. On the other hand, there has been little domestic research on the causative organism of urinary tract infection (UTI). This study investigated the influence of the COVID-19 pandemic on the distribution of causative organisms and the antimicrobial resistance rate in UTI.
Materials and Methods: This study analyzed 17,201 urine cultures retrospectively from patients who visited Chung-Ang University Hospital from January 2018 to December 2021. Tests were then conducted to determine if there was a significant difference between the data for the eight quarters of the pre-COVID-19 period (January 2018 to December 2019) and the data for the eight quarters post-COVID-19 period (January 2020 to December 2021).
Results: Escherichia coli was the most common causative organism in all periods, but it decreased in the post-COVID-19 period. Enterococcus faecalis increased in the post-COVID-19 period. The ciprofloxacin resistance rate of E. coli and Klebsiella pneumoniae increased, but the ciprofloxacin and levofloxacin resistance rate of E. faecalis decreased.
Conclusions: There was little difference in the causative organism distribution of UTI and antimicrobial resistance rates before and after the COVID-19 pandemic. On the other hand, changes in some causative organisms are identified. Nevertheless, because this study was limited to a single medical institute, data from a broader spectrum of bacterial species collected from multiple institutions will be needed to obtain definitive results.

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Trends in antimicrobial resistance of major gram-negative uropathogens, 2016–2024: A single center retrospective study
Jung-Ah Kim, Hyun-Seok Noh, Jae Heon Kim
Investigative and Clinical Urology.2026; 67(4): 383. CrossRef

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Microbiome Analysis Using Next-Generation Sequencing in Urinary Tract Infections: Hyunho Han, Joo Yong Lee; Urogenit Tract Infect 2022;17(1):1-7. Published online April 30, 2022; DOI: https://doi.org/10.14777/uti.2022.17.1.1

Abstract PDF PubReader ePub

In recent decades, the understanding of the genetic information of microbes and hosts has advanced considerably with the development of next-generation sequencing (NGS). For infectious diseases, genomic analysis can provide valuable information on the host disease susceptibility, microbial pathogenicity, and drug sensitivity. For urinary tract infections (UTI), NGS can reveal the pathogenic microbe and the dysbiosis of the urinary microbiome, which is a crucial factor in the pathogenesis of UTI and other urinary tract disorders. This review outlines the role of urinary microbiome dysbiosis in UTI, urinary stone disease, and cancer. Furthermore, the recent advances in NGS technologies for future applications in infectious disease research are described in detail.

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Next-Generation Sequencing Supports Targeted Antibiotic Treatment for Culture Negative Orthopedic Infections
Ellie J C Goldstein, Ravina Kullar, Emanuele Chisari, James Snyder, Christopher Cooper, Javad Parvizi, Jason Sniffen
Clinical Infectious Diseases.2023; 76(2): 359. CrossRef

5,817 View
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